“Chemo-Vitrectomy” for Macular Hole with Ocriplasmin :Case report

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“Chemo-Vitrectomy” for Macular Hole with Ocriplasmin

I am quite fortunate to be able to visit the Tun Hussain Onn National Eye Institute and Hospital, Petaling Jaya, Malaysia at least twice a year. Even more fortunate is the fact that whenever I come, Dr Pall Singh FRCS, FRCOphth, a very senior Vitreo-retina specialist of the hospital, almost always has a new and interesting case to share with me.

This time (Jan 2015) when I met him, he had a case of Idiopathic Macular hole to show me. We all see macular hole cases often enough. What was new was that he had given this case an intra-vitreal injection of Ocriplasmin, a recombinant proteolytic enzyme, 4 days earlier. The vision improved from 6/24 to 6/6P. Sharing the Fundus photo, pre-injection OCT and post-Injection OCT with you. Incredible results !

The injection is quite expensive though. In Malaysia it costs about RM 17,000/- (Approx. USD 4600/-). The patient was so pleased that he got the injection in the other eye as well yesterday. Hopefully he’ll get similar results in the other eye too.

Also sharing a photograph of me with Dr Natarajan Sundaram and Dr Pall Singh….

Thanks dear Dr Pall Singh…


Dr Sarbjit Singh
Consultant Ophthalmologist
Dr Shamsher Singh Eye Hospital
Khanna 141401 Punjab

Treatment of MacularHole with Ocriplasmin


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Update on Amblyopia & Strabismus Management | Dr Sameera Irfan

Update on Amblyopia & Strabismus Management FACTS REGARDING AMBLYOPIA : 1) Various animal studies have shown that in amblyopic eyes, the 2nd neurons in the Lateral Geniculate body and occipital cortical cells are not degenerated or dead (apoptosis), they are merely SHRUNKEN. Hence they can be made to work again. 2) Binocularly driven cells in…


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Scientific Programme of IIRSI 2015 at Chennai

 Scientific Programme of IIRSI 2015 at Chennai from July 4th – 5th, 2015 (Intra-Ocular Implant & Refractive Society of India) To Download the brochure of the programme please Click Here (1.6 MB pdf) On Behalf of : Prof Amar Aggarwal Dr. Agarwal’s eye hospital 19 cathedral road Chennai 600086 India (112) Like this:Like Loading… more

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Happy New Year 2015

Happy New Year 2015 Wishing all the members a very happy 2015. May we all share our experiences and knowledge even more in the coming year and strive to achieve academic excellence in the coming year. We owe it to ourselves and we owe it to our patients. Let us all resolve to always keep… more

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Management of Dry Eye Syndrome | Dr Sameera Irfan

Management of Dry Eye Syndrome | Dr Sameera Irfan FRCS To View the pdf document (209 kb) please click here   (378) Like this:Like Loading… more

Basic principles for spectacle prescription in children |Dr Sameera

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Basic principles for spectacle prescription in children

If every ophthalmologist in his/her practice donates one day in a month to screen kids with a COVER TEST and gives appropriate glasses, STRABISMUS WOULD DISAPPEAR 

except the congenital convergence insufficiecy and Essential infantile Et (causing a large angle XT & ET respectively)

Some basic principles for spectacle prescription in children:

1) After checking visual acuity in either eye, PERFORM A COVER TEST FOR NEAR (at 33 cm) and then at FAR distance ( 3 m).
2) If an ESOPHORIA OR ESOTROPIA is detected, even though the patient has a 6/6 VA in either eye, do an ATROPINE REFRACTION.
3) Give a FULL PLUS correction if the child is under 6 years age.
4) If the child is more than 6 yrs, do a SUBJECTIVE REFRACTION once the affect of atropine wears off i.e after 1 week and give MAXIMUM PLUS THAT THE CHILD CAN TOLERATE.
5) If on Cover Test, EXOPHORIA or EXOTROPIA is detected, then do a refraction with Cyclopentolate.
6) If you get a MINUS REFRACTION, GIVE ALL THE MINUS SPHERO-CYLINDER along with convergence exercises.
7) If you get a plus refraction, then change the cylinder to a MINUS IN THE OPPOSITE MERIDION (as illustrated by previous example).
8) If there is a zero refractive error but the child has an exophoria, if you do not treat it with a minus sphere of -0.75 D, this phoria will soon become a tropia.
 Similarly, an esophoria with zero refractive error will become a tropia soon if no plus glasses are given.
I hope these are very clear instructions.
best regards


Dr. Sameera Irfan, FRCS
Consultant Oculoplastic Surgeon & Strabismologist,
Mughal Eye Trust Hospital,
Lahore, Pakistan


Current Concepts in the Management of VKC | Dr Sameera Irfan

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Current Concepts in the Management of VKC | Dr Sameera Irfan

Vernal keratoconjunctivitis 1 is an acute-on-chronic inflammatory disease of conjunctiva and cornea, encountered in children with its onset usually in the first decade of life. Mild cases of VKC tend to remit with nonspecific and supportive therapy. But severe cases are more protracted, with frequent remissions and relapses; if not treated properly, it can result in sight-threatening complications2 over a period of time.

Pathogenesis: It is mainly a Type I (immediate) hypersensitivity reaction which occurs when a sensitized individual comes in contact with a specific antigen. However recent findings implicate more a complex pathogenesis with the involvement of T lymphocytes as well.1,2

These patients already exhibit large amounts of circulating Immunoglobulin E (IgE) which has a strong affinity for mast cells; the cross-linking of 2 adjacent IgE molecules by the antigen triggers mast cell degranulation.  This releases various preformed mediators of the inflammatory cascade like histamine, tryptase, chymase, heparin, chondroitin sulfate, prostaglandins, thromboxanes, and leukotrienes. These mediators (more…) (1021)

Cataracts From Statins? More Signals Emerge in Analyses

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Cataracts From Statins? More Signals Emerge in Analyses

VANCOUVER, BC — Statin therapy significantly elevates the risk of developing cataracts severe enough to warrant surgery, suggests analyses of two distinct cohorts, one from Canada and another from the US, that add to a hazy landscape of prior studies variously  concluding for or against such a risk for the widely used drugs[1].

For now, the possibility of such a risk from statins and its potential mechanisms should be explored in prospective trials, “especially in light of increased statin use for primary prevention of cardiovascular disease and the importance of acceptable vision in old age, when cardiovascular disease is common,” according to the report, published in the December 2014 issue of the Canadian Journal of Cardiology with lead author Dr Stephanie J Wise (University of British Columbia, Vancouver).

“However, because the relative risk is low and because cataract surgery is (more…) (296)

Inverted Side Cut LASIK Does Not Improve Dry Eye Symptoms

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Side Cut LASIK Does Not Improve Dry Eye Symptoms

Patients have superior recovery from laser-assisted in situ keratomileusis (LASIK) surgery if the LASIK flaps are made with an inverted side cut instead of a conventional side cut. Although corneal sensation is improved at year 1 with inverted side cuts, the improvement does not appear to translate into a significant improvement in subjective dry eye symptoms.

Jennifer S. Kung, MD, from the Byers Eye Institute, Stanford University School of Medicine, California, and colleagues published the results of their prospective randomized study in the December issue of Ophthalmology. The investigators randomized contralateral eyes. The comparative fellow-eye study included 120 eyes in 60 participants.

The cuts were made with two different lasers. The conventional 70° side cut was made with the 60 kHz IntraLase FS (Abbott Medical Optics), and the inverted 130° side cut was made with the 150 kHz IntraLase iFS (Abbott Medical Optics).

Patients were followed for 12 months (visits at months 1, 3, 6, and 12). Corneal sensation was measured by mean Cochet-Bonnet esthesiometry.

Preoperative corneal sensation was improved in eyes (more…) (258)

Macular Degeneration: Not All Supplements Equal, Experts Warn

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Macular Degeneration: Not All Supplements Equal, Experts Warn


Eye health claims made for some supplements are not supported by evidence, and the supplements could pose a risk to the user, researchers say.

“The scary thing is that the [US Food and Drug Administration] doesn’t regulate these supplements for safety or efficacy,” Jennifer J. Yong, MD, told Medscape Medical News.

Dr Yong, a resident at Yale-New Haven Hospital-Waterbury Hospital in Waterbury, Connecticut, and colleagues published a study examining supplement contents online November 20 in Ophthalmology.

Specific Formulas Are Proven

The Age-Related Eye Disease Study (AREDS), a randomized controlled trial published in 2001, showed that a specific formula of nutrients reduced the risk for vision loss from age-related macular degeneration in the intermediate and advanced stages of the disease.

The AREDS formula, made up of high doses of vitamin C, vitamin E, beta-carotene, and zinc, is patented by Bausch and Lomb.

It did not show any benefits in patients with cataracts, (more…) (349)

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